U.S. patent application number 10/100387 was filed with the patent office on 2002-10-24 for polyaxial locking plate.
Invention is credited to Bone, Lawrence B., Sanders, Roy W., Wack, Michael.
Application Number | 20020156474 10/100387 |
Document ID | / |
Family ID | 26797106 |
Filed Date | 2002-10-24 |
United States Patent
Application |
20020156474 |
Kind Code |
A1 |
Wack, Michael ; et
al. |
October 24, 2002 |
Polyaxial locking plate
Abstract
According to the present invention, a fracture repair system for
engagement with a bone is provided. The system includes a plate.
The plate has a body portion and an internal wall defining a plate
hole through the body portion. The system also includes one or more
bushings having a radially exterior surface and an opposite
radially interior surface defining a passageway. The exterior
surface of the bushings and the interior wall of the plate are
configured to permit polyaxial rotation of the bushings within the
plate hole. The system also includes an attachment component having
a distal portion sized for clearance passage through the passageway
and into the bone and an opposite proximate portion sized to press
the bushings against the internal wall of the plate to form a
friction lock between the bushings and the plate in a selected
polyaxial position. The attachment component is positionable in an
orientation extending divergently from the center of the plate.
Inventors: |
Wack, Michael; (Warsaw,
IN) ; Bone, Lawrence B.; (Buffalo, NY) ;
Sanders, Roy W.; (Tampa, FL) |
Correspondence
Address: |
AUDLEY A. CIAMPORCERO JR.
JOHNSON & JOHNSON
ONE JOHNSON & JOHNSON PLAZA
NEW BRUNSWICK
NJ
08933-7003
US
|
Family ID: |
26797106 |
Appl. No.: |
10/100387 |
Filed: |
March 18, 2002 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
60285462 |
Apr 20, 2001 |
|
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Current U.S.
Class: |
606/281 ;
606/287; 606/291; 606/298; 606/902; 606/907 |
Current CPC
Class: |
A61B 17/8057 20130101;
A61B 17/8061 20130101; A61B 17/1728 20130101; A61B 17/8047
20130101 |
Class at
Publication: |
606/69 |
International
Class: |
A61B 017/56 |
Claims
What is claimed is:
1. A fracture repair system for engagement with a bone, the system
comprising: a plate including a body portion and an internal wall
defining a plate hole through the body portion, a bushing including
a radially exterior surface and an opposite radially interior
surface defining a passageway, the exterior surface of said bushing
and the interior wall of said plate being configured to permit
polyaxial rotation of said bushing within the plate hole an
attachment component including a distal portion sized for clearance
passage through the passageway and into the bone and an opposite
proximate portion sized to press said bushing against the internal
wall of said plate to form a friction lock between said bushing and
said plate in a selected polyaxial position, said attachment
component being positionable in an orientation extending
divergingly from the center of said plate.
2. A fracture repair system as in claim 1 wherein said bushing
defines an axial opening on the periphery thereof from the radially
exterior surface through the opposite radially interior
surface.
3. A fracture repair system as in claim 1 wherein said plate
defines a surface thereof, the surface closely conforming to the
bone.
4. A fracture repair system as in claim 1: wherein said plate
further comprises a second internal wall defining a second plate
hole through the body portion, further comprising a second bushing
including a radially exterior surface and an opposite radially
interior surface defining a second passageway, the exterior surface
of the second bushing and the second interior wall of said plate
being configured to permit polyaxial rotation of said second
bushing within the second plate hole, and further comprising a
second attachment component including a distal portion sized for
clearance passage through the second passageway and into the bone
and an opposite proximate portion sized to press said second
bushing against the internal wall of said plate to form a friction
lock between said second bushing and said plate in a selected
polyaxial position, said second attachment component being
positionable in an orientation extending divergently from the
center of said plate.
5. A fracture repair system as in claim 1: wherein the radially
exterior surface of said bushing comprises a truncated spherical
shape and wherein the internal wall defining the plate hole
comprises a truncated spherical shape.
6. A fracture repair system as in claim 1: wherein said attachment
component comprises first external threads on the proximate portion
thereof and second external threads on the distal portion thereof,
and wherein the radially interior surface of said bushing comprises
first internal threads thereon, said first internal threads of said
bushing engageable with said first internal threads of said
attachment component.
7. A fracture repair system as in claim 1 wherein at least one of
said first internal threads of said bushing and said first internal
threads of said attachment component are tapered.
8. A fracture repair system as in claim 1: wherein said plate
includes a second internal wall defining a second plate hole, said
second internal wall defining internal threads; and further
comprising a second attachment component defining external threads
thereon, said second attachment component threadably secured to
said plate.
9. A knee fracture repair system for engagement with a bone, the
system comprising: a femur plate including a body portion
conforming at least partially to the contour of the femur and an
internal wall defining a femur plate hole through the body portion,
a tibia plate including a body portion conforming at least
partially to the contour of the tibia and an internal wall defining
a tibia plate hole through the body portion, a bushing including a
radially exterior surface and an opposite radially interior surface
defining a passageway, the exterior surface of the bushing and the
interior wall of said plate being configured to permit polyaxial
rotation of the bushing within at least one of the femur plate hole
and the tibia plate hole, and an attachment component including a
distal portion sized for clearance passage through the passageway
and into the bone and an opposite proximate portion sized to press
the bushing against the internal wall of the plate to form a
friction lock between the bushing and at least one of the femur
plate hole and the tibia plate hole in a selected polyaxial
position.
10. A knee fracture repair system as in claim 9 wherein said
bushing defines an axial opening on the periphery thereof from the
radially exterior surface through the opposite radially interior
surface
11. A knee fracture repair system as in claim 9 wherein said
attachment component is positionable in an orientation extending
divergently from the center of the plate.
12. A knee fracture repair system as in claim 9: wherein the plate
further comprises a second internal wall defining a second plate
hole through the body portion, further comprising a second bushing
including a radially exterior surface and an opposite radially
interior surface defining a second passageway, the exterior surface
of the second bushing and the second interior wall of said plate
being configured to permit polyaxial rotation of the second bushing
within the second plate hole, and further comprising a second
attachment component including a distal portion sized for clearance
passage through the second passageway and into the bone and an
opposite proximate portion sized to press the second bushing
against the internal wall of the plate to form a friction lock
between the second bushing and the plate in a selected polyaxial
position, said second attachment component being positionable in an
orientation extending divergently from the center of the at least
one of the femur plate hole and the tibia plate hole.
13. A knee fracture repair system as in claim 9: wherein the
radially exterior surface of said bushing comprises a truncated
spherical shape and wherein the internal wall defining the plate
hole comprises a truncated spherical shape.
14. A knee fracture repair system as in claim 9: wherein said
attachment component comprises first external threads on the
proximate portion thereof and second external threads on the distal
portion thereof, and wherein the radially interior surface of said
bushing comprises first internal threads thereon, said first
internal threads of said bushing engageable with said first
internal threads of said attachment component.
15. A knee fracture repair system as in claim 9 wherein at least
one of said first internal threads of said bushing and said first
internal threads of said attachment component are tapered.
16. A knee fracture repair system as in claim 9: wherein at least
one of said femur plate and said tibia plate includes a second
internal wall defining a second plate hole, said second internal
wall defining internal threads; and further comprising a second
attachment component defining external threads thereon, said second
attachment component threadably secured to said at least one of
said femur plate and said tibia plate.
17. A femur plate for use in a knee fracture repair system for
engagement with a bone, the femur plate comprising: A plate portion
including a body portion conforming at least partially to the
contour of the femur and an internal wall defining a femur plate
hole through the body portion, a bushing including a radially
exterior surface and an opposite radially interior surface defining
a passageway, the exterior surface of the bushing and the interior
wall of said plate portion being configured to permit polyaxial
rotation of the bushing within the plate hole, and an attachment
component including a distal portion sized for clearance passage
through the passageway and into the bone and an opposite proximate
portion sized to press the bushing against the internal wall of the
plate portion to form a friction lock between the bushing and the
plate portion in a selected polyaxial position, said attachment
component being positionable in an orientation extending
divergently from the center of the plate portion.
18. A femur plate as in claim 17 wherein said bushing defines an
axial opening on the periphery thereof from the radially exterior
surface through the opposite radially interior surface
19. A femur plate as in claim 17 wherein said attachment component
is positionable in an orientation extending divergently from the
center of the plate.
20. A femur plate as in claim 17 wherein: wherein the plate further
comprises a second internal wall defining a second plate hole
through the body portion, further comprising a second bushing
including a radially exterior surface and an opposite radially
interior surface defining a second passageway, the exterior surface
of the second bushing and the second interior wall of said plate
being configured to permit polyaxial rotation of the second bushing
within the second plate hole, and further comprising a second
attachment component including a distal portion sized for clearance
passage through the second passageway and into the bone and an
opposite proximate portion sized to press the second bushing
against the internal wall of the plate to form a friction lock
between the second bushing and the plate in a selected polyaxial
position, said second attachment component being positionable in an
orientation extending divergently from the center of the plate.
21. A femur plate as in claim 17: wherein the radially exterior
surface of said bushing comprises a truncated spherical shape and
wherein the internal wall defining the plate hole comprises a
truncated spherical shape.
22. A femur plate as in claim 17: wherein said attachment component
comprises first external threads on the proximate portion thereof
and second external threads on the distal portion thereof, and
wherein the radially interior surface of said bushing comprises
first internal threads thereon, said first internal threads of said
bushing engageable with said first internal threads of said
attachment component.
23. A femur plate as in claim 17: wherein said plate portion
includes a second internal wall defining a second plate hole, said
second internal wall defining internal threads; and further
comprising a second attachment component defining external threads
thereon, said second attachment component threadably secured to
said plate portion.
24. A tibia plate for use in a knee fracture repair system for
engagement with a bone, the tibia plate comprising: a plate portion
including a femur plate including a body portion conforming at
least partially to the contour of the femur and an internal wall
defining a femur plate hole through the body portion, a bushing
including a radially exterior surface and an opposite radially
interior surface defining a passageway, the exterior surface of the
bushing and the interior wall of said plate being configured to
permit polyaxial rotation of the bushing within the plate hole, and
an attachment component including a distal portion sized for
clearance passage through the passageway and into the bone and an
opposite proximate portion sized to press the bushing against the
internal wall of the plate to form a friction lock between the
bushing and the plate in a selected polyaxial position, said
attachment component being positionable in an orientation extending
divergently from the center of the plate
25. A tibia plate as in claim 24, wherein said bushing defines an
axial opening on the periphery thereof from the radially exterior
surface through the opposite radially interior surface
26. A tibia plate as in claim 24, wherein said attachment component
is positionable in an orientation extending divergently from the
center of the plate.
27. A tibia plate as in claim 24, wherein: wherein the plate
further comprises a second internal wall defining a second plate
hole through the body portion, further comprising a second bushing
including a radially exterior surface and an opposite radially
interior surface defining a second passageway, the exterior surface
of the second bushing and the second interior wall of said plate
being configured to permit polyaxial rotation of the second bushing
within the second plate hole, and further comprising a second
attachment component including a distal portion sized for clearance
passage through the second passageway and into the bone and an
opposite proximate portion sized to press the second bushing
against the internal wall of the plate to form a friction lock
between the second bushing and the plate in a selected polyaxial
position, said second attachment component being positionable in an
orientation extending divergently from the center of the plate.
28. A tibia plate as in claim 24: wherein the radially exterior
surface of said bushing comprises a truncated spherical shape and
wherein the internal wall defining the plate hole comprises a
truncated spherical shape.
29. A tibia plate as in claim 24: wherein said attachment component
comprises first external threads on the proximate portion thereof
and second external threads on the distal portion thereof, and
wherein the radially interior surface of said bushing comprises
first internal threads thereon, said first internal threads of said
bushing engageable with said first internal threads of said
attachment component.
30. A tibia plate as in claim 24 wherein at least one of said first
internal threads of said bushing and said first internal threads of
said attachment component are tapered.
31. A tibia plate as in claim 24: wherein said plate portion
includes a second internal wall defining a second plate hole, said
second internal wall defining internal threads; and further
comprising a second attachment component defining external threads
thereon, said second attachment component threadably secured to
said plate portion.
32. A method for coupling two bone portions together, the method
comprising the steps of: providing a locking plate apparatus
including a plate having a body portion and at least two plate
holes through the body portion, a bushing movably coupled in each
plate hole and having a radially exterior surface, an opposite
interior surface, and first and second ends defining a passageway
therebetween, and at an attachment component for each bushing sized
for extension into the passageway, each attachment component
including opposite leading and trailing portions, positioning the
body portion upon the bone portions so that the plate holes in the
plate are situated over bone, rotating at least one bushing within
the plate hole until the first and second ends of the bushing are
aligned along an axis that extends through a pre-determined portion
of the bone, inserting the leading portion of the attachment
components into the respective passageway, and driving the trailing
portion of each attachment component through the respective
passageway until the leading portion is positioned in the bone and
the exterior surface of the bushing is pressed against the body
portion to form a friction lock therebetween.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This Application is a Utility Application based upon U.S.
Provisional Patent Application, Serial No. 60/285,462 filed Apr.
20, 2001, entitled POLYAXIAL LOCKING PLATE.
BACKGROUND SUMMARY OF THE INVENTION
[0002] The present invention relates to a bone locking plate, more
particularly the present invention relates to a bone locking plate
that includes an adjustable attachment component. Most
particularly, the present invention relates to a bone locking plate
that includes an attachment component whose angle relative to the
locking plate may be manipulated during surgery so that an
accompanying screw extends into the bone in a desirable
orientation.
[0003] The skeletal system includes many long bones which extend
from the human torso. These long bones include the femur, fibula,
tibia, humerus, radius and ulna. These long bones are particularly
exposed to trauma from accidents and as such often are fractured
during such trauma and may be subject to complex devastating
fractures.
[0004] Automobile accidents for instance are a common cause of
trauma to long bones. In particular the femur and tibia frequently
fracture when the area around the knee is subjected to a frontal
automobile accident.
[0005] Often the distal and/or proximal portions of the long bone,
for example, the femur and tibia are fractured into several
components and must be re-attached.
[0006] Mechanical devices most commonly in the form of pins, plates
and screws are commonly used to attach fractured long bones. The
plates, pins and screws are typically made of a durable material
compatible with the human anatomy, for example titanium, stainless
steel or cobalt chrome. The plates are typically positioned
longitudinally along the periphery of the long bone and have holes
or openings through which screws may be inserted into the long bone
transversely. Additionally, intramedullary nails or screws may be
utilized to secure fractured components of a long bone, for
example, to secure the head of a femur.
[0007] Fractures of long bones typically occur in high stress
areas, for example, near the condyles or distal or proximal
portions of the long bones. Such fractures in the distal or
proximal condyle portions of the long bone may result in many
individual fragments which must be reconnected. Optimally, the bone
plates should be positioned adjacent to the distal or proximal
portions of the long bones and permit the securing of these
fragments.
[0008] More recently bone plates have been provided for long bones
which have a profile which conforms to the distal or proximal
portion of the long bone. For example such bone plates are
available from DePuy ACE in the form of supra condylar plate
systems. These plates have a contoured periphery to match the
distal portion of a long bone, for example, a femur. These plates,
however, include holes or opening through which transverse screws
are used to secure the bone plate to the long bone. The openings in
the bone plate provide thus for only one general orientation of the
screw for attachment of the bone fragments, which is normally or
perpendicularly to the bone plate. Thus often the optimum position
of a screw may not be utilized as it does not conform to a position
nominal or perpendicular to the bone plate.
[0009] Often with a fracture of condyles of the distal portion of a
long bone the adjacent screws should be positioned and locked in a
divergent direction diverging from the bone plate so that the
distal condyles may be properly secured by the bone screw. Two
dimensional bone plates do not provide for the optimum diverging
orientation of the bone screws.
[0010] Recently DePuy Acromed, Inc. has developed locking plates,
as disclosed in U.S. Pat. No. 5,954,722 to Bono, for use in spinal
applications which include a pivotable bushing within the plate
which bushing is internally threaded and mates with external
threads on bone screws. This type of locking plate permits an
orientation of the bone screw in a position other than normally
with the bone plate while also permitting locking of the screw.
[0011] What is needed is a bone plate assembly that permits the
stress free securing of condylar distal or proximal portions of a
long bone to a locking plate and allows for diverging locking
orientation of adjacent bone screws within a bone plate to
optimally secure the fragments from a long bone trauma.
[0012] According to the present invention, a fracture repair system
for engagement with a bone is provided. The system includes a
plate. The plate has a body portion and an internal wall defining a
plate hole through the body portion. The system also includes a
bushing having a radially exterior surface and an opposite radially
interior surface defining a passageway. The exterior surface of the
bushing and the interior wall of the plate are configured to permit
polyaxial rotation of the bushing within the plate hole. The system
also includes an attachment component having a distal portion sized
for clearance passage through the passageway and into the bone and
an opposite proximate portion sized to press the bushing against
the internal wall of the plate to form a friction lock between the
bushing and the plate in a selected polyaxial position. The
attachment component is positionable in an orientation extending
divergently from the center of the plate.
[0013] According to another embodiment of the present invention a
knee fracture repair system for engagement with a bone is provided.
The system includes a femur plate including a body portion
conforming at least partially to the contour of the femur and an
internal wall defining a femur plate hole through the body portion.
The system also includes a tibia plate including a body portion
conforming at least partially to the contour of the tibia and an
internal wall defining a tibia plate hole through the body portion.
The system further includes a bushing including a radially exterior
surface and an opposite radially interior surface defining a
passageway. The exterior surface of the bushing and the interior
wall of the plate are configured to permit polyaxial rotation of
the bushing within at least one of the femur plate holes and the
tibia plate holes. The system also includes an attachment component
including a distal portion sized for clearance passage through the
passageway and into the bone and an opposite proximate portion. The
proximate portion is sized to press the bushing against the
internal wall of the plate to form a friction lock between the
bushing and at least one of the femur plate holes and the tibia
plate holes in a selected polyaxial position.
[0014] Still further, in accordance with the present invention a
femur plate for use in a knee fracture repair system for engagement
with a bone is provided. The femur plate includes a plate portion
having a body portion conforming at least partially to the contour
of the femur and an internal wall defining a femur plate hole
through the body portion. The femur plate also includes a bushing
including a radially exterior surface and an opposite radially
interior surface defining a passageway. The exterior surface of the
bushing and the interior wall of the plate portion are configured
to permit polyaxial rotation of the bushing within the plate hole.
The femur plate includes an attachment component including a distal
portion sized for clearance passage through the passageway and into
the bone and an opposite proximate portion. The proximate portion
is sized to press the bushing against the internal wall of the
plate portion to form a friction lock between the bushing and the
plate portion in a selected polyaxial position. The attachment
component is positionable in an orientation extending divergently
from the center of the plate portion.
[0015] In yet another embodiment of the present invention, a tibia
plate for use in a knee fracture repair system for engagement with
a bone is provided. The tibia plate includes a plate portion having
a body portion conforming at least partially to the contour of the
femur and an internal wall defining a femur plate hole through the
body portion. The tibia plate also includes a bushing having a
radially exterior surface and an opposite radially interior surface
defining a passageway. The exterior surface of the bushing and the
interior wall of the plate are configured to permit polyaxial
rotation of the bushing within the plate hole. The tibia plate
further includes an attachment component having a distal portion
sized for clearance passage through the passageway and into the
bone and an opposite proximate portion. The proximate portion is
sized to press the bushing against the internal wall of the plate
to form a friction lock between the bushing and the plate in a
selected polyaxial position. The attachment component is
positionable in an orientation extending divergently from the
center of the plate.
[0016] In still another embodiment of the present invention, a
method for coupling two bone portions together is provided. The
method includes the step of providing a locking plate apparatus
including a plate having a body portion and at least two plate
holes through the body portion, a bushing movably coupled in each
plate hole and having a radially exterior surface, an opposite
interior surface, and first and second ends defining a passageway
therebetween, and at an attachment component for each bushing sized
for extension into the passageway. Each attachment component
includes opposite leading and trailing portions. The method also
includes the steps of positioning the body portion upon the bone
portions so that the plate holes in the plate are situated over
bone and rotating at least one bushing within the plate hole until
the first and second ends of the bushing are aligned along an axis
that extends through a pre-determined portion of the bone. The
method also includes the steps of inserting the leading portion of
the attachment components into the respective passageway and
driving the trailing portion of each attachment component through
the respective passageway until the leading portion is positioned
in the bone and the exterior surface of the bushing is pressed
against the body portion to form a friction lock therebetween.
[0017] Additional objects, features, and advantages of the
invention will become apparent to those skilled in the art upon
consideration of the following detailed description of the
preferred embodiment exemplifying the best mode of carrying out the
invention as presently perceived.
BRIEF DESCRIPTION OF THE DRAWINGS
[0018] FIG. 1 is a plan lateral view of a fracture repair system in
accordance with the present invention with a femur plate coupled to
a femur and a tibia plate coupled to a tibia;
[0019] FIG. 2 is a perspective lateral view of a fracture repair
system in accordance with the present invention with a femur plate
coupled to a femur and a tibia plate coupled to a tibia;
[0020] FIG. 3 is a perspective view of a femur plate in accordance
with the present invention;
[0021] FIG. 4 is a plan view of a the femur plate of FIG. 3;
[0022] FIG. 5 is an enlarged plan view of a the femur plate of FIG.
3;
[0023] FIG. 6 is a cross section view of the femur plate of FIG. 5
taken along lines 6-6;
[0024] FIG. 6A is a cross section view of the femur plate of FIG. 5
taken along lines 6A-6A;
[0025] FIG. 7 is a perspective view of a tibia plate in accordance
with the present invention;
[0026] FIG. 8 is a plan view of a the tibia plate of FIG. 7;
[0027] FIG. 9 is a cross section view of the tibia plate of FIG. 8
taken along lines 9-9;
[0028] FIG. 10 is a plan view of a cannulated, cancellous bone
screw for attachment to cancellous bone of a long bone for use with
the fracture repair system of FIG. 1;
[0029] FIG. 11 is a partial cross sectional view of the tibia plate
of FIG. 8 taken along lines 11-11 showing a portion of the tibia
plate coupled to the tibia with the tibia plate in cross section
and showing various bone screws positioned in the femur;
[0030] FIG. 12 is a partial cross sectional view of the femur plate
of FIG. 4 taken along lines 12-12 showing a portion of the femur
plate coupled to the femur with the femur plate in cross section
and showing two of the bone screws of FIG. 14 positioned in
divergent positions in the condyles of the femur in accordance with
the present invention;
[0031] FIG. 12A is a partial cross sectional view of the femur
plate of FIG. 4 taken along lines 12A-12A showing a portion of the
femur plate coupled to the femur with the femur plate in cross
section and showing the bone screw of FIG. 10 positioned in the
condyles of the femur;
[0032] FIG. 13 is a plan view of a cortical bone screw for
attachment to both cortical bone surfaces of a long bone and for
engagement with the bone plate for use with the femur plate of FIG.
4;
[0033] FIG. 14 is a plan view of a bone screw for engagement with
the bone plate installed in a bone plate according to the present
invention with a portion of the bone plate and a bushing providing
polyaxial rotation shown in cross section;
[0034] FIG. 15 is a top view of a bushing for providing polyaxial
rotation of the bone screw according to the present invention;
[0035] FIG. 16 is a plan view shown in cross section of the bushing
of FIG. 15;
[0036] FIG. 17 is a plan view of a drill guide instrument installed
on a bone plate for use with the fracture repair system of FIGS.
1-16; and
[0037] FIG. 18 is a plan view of a cancellous bone screw for
attachment to cancellous bone of a long bone for use with the
fracture repair system of FIG. 1.
DETAILED DESCRIPTION OF THE DRAWINGS
[0038] According to the present invention and referring now to FIG.
6, a fracture repair system 10 is shown for engagement with a long
bone 12. The long bone 12 may be any long bone, for example, a
femur, tibia, fibula, humerus, radius or ulna, but as shown in FIG.
1 the long bone is a femur. The fracture repair system 10 includes
a plate 14.
[0039] Referring now to FIG. 4 the fracture repair system 14 is
shown in greater detail. The plate 14 may be made of any suitable
durable material and may, for example, be made of a metal, for
example, a metal compatible with the human anatomy, for example,
cobalt chrome, stainless steel or titanium. The plate 14 includes a
body portion 16 and an interior wall 20. The interior wall 20
defines a plate hole 22 through the body portion 16.
[0040] Referring now to FIG. 12 the fracture repair system 10 is
shown in greater detail. In addition to the plate 14 the fracture
repair system 10 includes one or more bushings 24. The bushing 24
includes a radial exterior surface 26 and opposite radial interior
surface 30. The opposite radial interior surface 30 defines a
passageway 32 through the bushing 24. The exterior surface 26 of
the bushing 24 and the interior wall 20 of the plate 14 are
configured to permit the polyaxial rotation of the bushing 24
within the plate hole 22. (see FIG. 12) Such polyaxial rotation may
be permitted by providing an arcuate or spherical surface on the
interior wall 20 of the plate 14 and a mating arcuate or spherical
surface on the radial exterior surface 26 of the bushing 24.
[0041] The fracture repair system 10 further includes the
attachment component 34 includes a distal portion 36 sized for
current passage through the passageway 32 and into the long bone
12. The attachment component 34 further includes an opposite
proximal portion 40 sized to press the bushing 24 against the
internal wall 20 of the plate 14 to form a friction lock between
the bushing 24 and the plate 14 in a selected polyaxial position.
The attachment component 34 is positionable in an orientation
extending divergently from the center of the plate.
[0042] Referring now to FIGS. 3 through 6 the fracture repair
system 10 is shown as femur plate assembly 10. Preferably and as
shown in FIGS. 3-6, the body portion 16 of the femur plate 14
preferably includes a proximal portion 42 and distal portion 44. To
provide for optimal support of the femur, the femur plate 14 has a
shape generally conforming to the outer periphery of the femur 12.
The proximal portion 42 of the bone plate 14 is generally flat or
planer in conforming to the general flat or planer nature of the
proximal shaft portion of the femur. The femur plate 14 may have a
bow to accommodate the natural anterior/posterior bow of the femur
12. The distal portion 44 of the femur plate 14 has a shape
generally conforming to the condylar portion 46 of the femur 12.
Since the condylar portion 46 of the femur 12 is arcuate or curved
the distal portion 44 of the femur plate 14 is preferably curved to
mate with condyles 50 of the condyle portion 46 of the femur
12.
[0043] While the particular size and shape and dimensions of the
femur plate 14 may vary widely depending upon the size of the femur
on which it is installed, for an adult human femur, the plate 14
may have, for example as shown in FIG. 4, an overall length L of
about 6 to 14 inches and a width W of about 11/4 to 3/4 of an inch
and a thickness T of, for example as shown in FIG. 6, about 1/8-1/4
inch. Since the human anatomy is generally symmetrical, the femur
plate 14 is either a right hand or left hand femur plate and the
right hand and left-hand femur plates are different, but generally
symmetrical with each other.
[0044] While the fracture repair system of the present invention
includes one or more bushings which cooperates with an attachment
component such that the attachment component may be positionable in
an orientation diverging from the center of the plate, it should be
appreciated that the fracture system or plate may include a
plurality of attachment components. Further these attachment
components may be of different styles or types.
[0045] Referring now to FIG. 6, the femur plate 14 is shown with
three different types of attachment components. Solid,
fully-threaded, cortical screws 52 are positioned in elongated
openings 54 shown in FIG. 4 in the proximal portion 42 of the femur
plate 14. The fully-threaded cortical screws 52 may, as shown in
FIG. 6, be self-tapping and cut threads while they are being
screwed through the plate into the bone during surgery. The
cortical screws 52 are supported primarily by the cortical bone to
which they have been secured. While the proximal portion 42 of the
bone plate 14 may be secured by a solitary cortical screw 52
preferably and, as shown in FIG. 6, the proximal portion 42 of the
femur plate 14 is supported by a series of several spaced apart
fully threaded cortical bone screws.
[0046] To provide ample support for the proximal portion 42 of the
plate 14 and to provide for a standard commercially available femur
plate 14, the femur plate 14 preferably includes a uniformly spaced
apart pattern of elongated openings 54 shown in FIG. 4. The surgeon
may choose any of a number of the elongated openings 54 shown in
FIG. 4 in which to drill and screw the cortical screws. Depending
on the position of the fractures as few as two or three cortical
screws may be sufficient to support the femur plate 14.
[0047] Continuing to refer to FIG. 6, cancellous screws 56 may also
be placed in the elongated openings 54 and used to secure the
proximal portion 42 of the femur plate 14.
[0048] The screw 56 unlike cancellous screw 70 (see FIG. 6) does
not include threads on the head of screw 56. The lack of screw
threads on the head of screw 56 allows the head to spin on the
bushing 24 without locking, thereby achieving a lagging effect. The
cancellous screws 56 may be any suitable size and may, for example,
be 2 to 6 millimeters solid, cancellous, partially or fully
threaded cancellous screws. The cancellous screws 56, preferably
have a length less than the thickness of the femur so that they may
not protrude from the opposite surface of the femur.
[0049] Distal portion 44 of the femur plate 14 is designed to
follow the general contours of the lateral distal femur while the
proximal portion 42 incorporates the natural bow of the femur.
[0050] The femur plate 14 may include one or more tapped openings
60 in the femur plate 14 which may be utilized to secure a drill
guide 200 shown in FIG. 17 for aligning a drill and a screw driver
for the insertion of the screws 52 and 56 into the femur. The drill
guide 200 will be described in greater detail later.
[0051] According to the present invention, the plate 14 includes
attachment components which are positionable in an orientation
diverging from the center of the plate. The plate 14 thus includes
at least one screw 70 which is secured to the plate 14 by means of
the bushing 24. The screw 70 may be in the form of a cancellous
screw. The cancellous screw is particularly well suited for
securing the condylar portion of the distal portion of the femur.
The cancellous screw 70 may be partially or fully threaded and may
have any suitable length to reach the proper portion of the
fractured condylar portion of the distal femur. For example, the
cancellous screw may have a length from 20 to 150 millimeters. The
cancellous screw may have a suitable diameter to properly secure
the fractured portions of the femur. For example, the cancellous
screw may have a diameter of 3 to 10 millimeters. The cancellous
screw 70 is used to secure the distal portion of the femur plate to
the bone.
[0052] The cancellous screws may be rotated from the first position
72 shown in solid to position 74 shown rotated an angle cc or to a
third position 76 rotated in the opposite direction an angle .beta.
(see FIG. 6). If the cancellous screw 70 is rotated to the second
position 74, the screw 70 will be utilized to secure fragment AA
while, if the cancellous screw 70 is rotated to position 76, the
cancellous screw 70 may be utilized to secure fragment BB. The tip
of the cancellous screws 70 can therefore be rotated in a conical
pattern.
[0053] The cancellous screw 70 as shown in FIG. 6 may include
external threads 80 on the head or proximal portion of the screw
70. Alternatively, the head or proximal portion may have a smooth
conical head. The external threads 80 mate with internal threads 82
on the bushing 24. Preferably and as shown in FIG. 6 the external
threads 80 are tapered such that as the external threads 80 of the
screw 70 are engaged into the bushing 24 the bushing 24 expands,
locking the radial external surface 26 of the bushing 24 to the
radial interior surface 30 of the plate 14.
[0054] By permitting the bushing 24 to rotate within the plate 14
and by permitting the bushing 24, the screw 70 and the plate 14 to
all be locked securely in place, the screw may be fixedly
positioned in many different orientations, while maintaining all
components at minimal stress. As shown in FIG. 6, the feature of
having the positionable screw and plate configuration permits
either fragment AA or fragment BB to be secured by the screw
70.
[0055] Referring now to FIG. 6A, one or any portion of the
locations of the plate 14 may include one or more bushings 124
which may alternatively be utilized with a screw having a
non-threaded head. For example, as shown in FIG. 6A a cancellous
screw 170 is shown similar to screw 70 but not including external
threads on the head of the screw. The screw 170 does include
cancellous threads 172 for securement to the cancellous bone. The
screw 170 includes a head 174 which is secured against face 176 of
bushing 124. In this configuration the bushing 124 serves to permit
the rotation of the screw 170 in the direction of arrows 100 and
102, thus permitting the orientation of the screw 170. The use of
the bushing 124 prevents stress risers on the head 174 or face 176
of the bushing 124.
[0056] The plate 14 may be made of any suitable durable material
that is biologically compatible with the human anatomy and
preferable made of a high strength metal. For example, the plate
may be made of stainless steel, cobalt chrome or titanium.
Preferably the plate 14 is manufactured from a forged or wrought
titanium alloy. One such suitable alloy is ASTM F-620-97 and
another suitable alloy is ASTM F-136 ELI.
[0057] Referring to FIG. 7, the femoral plate 314 may be secured to
the femur 312 during surgery either percutaneously or by
conventional open surgery. When the femur plate 314 and screws are
implanted in conventional open surgery a longitudinal cut 390 is
made through the skin along the thigh 308 laterally where the femur
plate is typically installed. A lateral installation of the femur
plate provides for the minimal interference with muscle, ligaments
and other soft tissue. A longitudinal cut 306 in the thigh 308
through the skin parallel to the femur 312 is made approximately
the length of the femur plate 314 and the soft tissue is pulled
apart so that the femur plate may be placed in position. Cancellous
and cortical screws are then positioned over their respective
openings in the femur plate 314 and secured to the femur 312.
[0058] When performing percutaneous surgery the skin of the thigh
308 is opened laterally near the knee and a transverse cut 392 is
made and femur plate 314 is inserted at that opening and guided
against the femur 312 proximally toward the hip. The proximal end
of the femur plate 314 may include a contoured tip 384 to ease the
percutaneous installation of the femur plate 314.
[0059] While the femur plate 314 may be made of any suitable size
depending on the size of the human in which the plate is to be
installed, the femoral plates 314 may be available in various
lengths so that they will be available when trauma strikes. For
example, the femoral plates may be provided with varying lengths
including for example 5, 8, 11, 14 or 18 screw holes in the
shaft.
[0060] The cortical and cancellous screws are manufactured of any
suitable durable material that are typically manufactured of a
wrought titanium alloy for example ASTM F-136 ELI.
[0061] Referring now to FIG. 12A, the femur plate 14 may further
include a cannulated cancellous screw for positioning in the
condylar portion 46 of the femur 12. The cannulated cancellous
screw 62 preferably has a length slightly shorter than the length
of the portion of the cancellous bone at the condylar portion 46
such that the cannulated cancellous screw does not contact the
opposite cortical bone. The cannulated cancellous screw may, for
example, be 8 millimeter cannulated cancellous and preferably as
shown in FIG. 12A include external threads 48 located on proximal
portion 38 of the cancellous screw 46. The external threads 48 mate
with the internal threaded opening 49 of the distal portion 44 of
the femur plate 14. The cannulated cancellous screw 62 provides
additional structural support to the condylar portion 46 of the
femur 12. Alternatively, the head of the cancellous screw 62 may be
smooth, thereby allowing the head to spin in the plate without
locking. The spinning achieves a lagging effect, i.e. drawing the
fragments together.
[0062] Referring now to FIG. 10, the cannulated cancellous screw 62
is shown in greater detail. The cannulated cancellous screw may not
be in any particular size and may include a diameter D1 of, for
example, 4 to 10 millimeters. The cannulated cancellous screw has a
length L1 sufficient to occupy most of the condylar portion 46 of
the femur or long bone 12. To provide for rigid attachment of the
cannulated cancellous screw 62 to the bone plate 14, the cancellous
screw 62 preferably includes a head 410 having external threads 412
which may mate with internal threaded opening 49 of the bone plate
14 (see FIG. 12A). The cannulated cancellous screw 62 includes
external threads 414 and may include an unthreaded shank portion
416. The cannulated cancellous screw 62 may include a self-tapping
tip 420 which may also serve as a self-drilling as well as a
self-tapping tip. As shown in FIG. 10, the threads 412 on the head
410 are tapered to provide for a tight locking fit with the bone
plate 14. The cannulated cancellous screw 62 is by definition
cannulated or includes a central longitudinal opening 422.
[0063] Referring now to FIG. 13 a cortical screw 52 is shown. The
cortical screw 52 includes threads 514 which are adapted for
securing cortical bone. The cortical screw 52 may include an
unthreaded shank portion (not shown). The cortical screw 52
includes a head 552 which may, as shown in FIG. 13, have a
generally oval shape. The cortical screw 52 may also include a
self-tapping tip 520 which may also include self-drilling
provisions. The cortical screw 52 has a length L2 which preferably
is of sufficient length to engage the cortical bone on the opposite
or exit side of the bone. The cortical screw 52 further includes a
thread diameter D2 which is of sufficient size to provide
sufficient holding power and engagement with the cortical bone. For
example and as shown in FIG. 13, the cortical screw 52 has a
diameter D2 of, for example, 3.5 to 6 millimeters.
[0064] Referring now to FIG. 14 an attachment component according
to the present invention is showed as cancellous screw 70. The
screw 70 includes a distal portion 36 which has an outside diameter
OD which is less than the inside diameter ID of the internal wall
or surface 30 of the plate hole 22. The screw 70 further includes
external threads 80 located on the proximal portion 40 of the screw
70. Preferably and as shown in FIG. 14, the external threads 80 are
tapered. The external threads 80 are mateably engageable with the
internal threads 82 on the bushing 24. The bushing 24 is pivotally
engageable with the plate 14. The radially exterior surface 26 of
the bushing 24 has a generally spherical shape and is mateably
fitted with the interior wall or surface 30 of the plate hole 22.
The interior threads 82 of the bushing 24 is larger than the
outside diameter of cancellous threads 71 on the screw 70 to permit
the distal portion of the 36 of the screw 70 to slidably pass or
thread through the plate hole 22. The cancellous threads 71 are
adapted for efficient engagement with cancellous bone 96 and the
screw 70 has a length L3 which is sized to provide for the
cancellous thread 71 to engage a significant portion of the
cancellous bone 96.
[0065] Referring now to FIG. 18, a fully threaded cancellous screw
56 is shown for use with the bone plate 14. The cancellous screw 56
includes a head 610. The head 610 may have any suitable shape and
may, for example, be flat head as shown in FIG. 18 or have a pan
head shape. The screw 56 unlike cancellous screw 70 (see FIG. 6)
does not include threads on the head of screw 56. The lack of screw
threads on the head of screw 56 allows the head to spin on the
bushing 24 without locking, thereby achieving a lagging effect. The
cancellous screw 56 has a length L4 to provide for engagement with
a suitable portion of the cancellous bone (not shown). The
cancellous screw has threads 614 which are adapted for engagement
with cancellous bone. The thread 614 has a diameter D4 which is
sized for efficient and effective support and engagement with the
cancellous bone. For example, the cancellous screw 56 may have a
diameter D4 of, for example 2 to 6 millimeters. The cancellous
screw 56 further includes a tip 620. The tip 620 may optionally
include self-drilling and/or self-tapping features.
[0066] Referring now to FIG. 15, the bushing 24 is shown in greater
detail. The bushing or collet is manufactured of any suitable
durable material that is compatible with the human body. For
example the collet may be made of cobalt chrome, stainless steel or
titanium. For example the bushing 24 may be manufactured of a
wrought titanium alloy. Such a wrought titanium alloy is ASTM F-136
ELI.
[0067] The bushing 24 preferably includes a radial opening or
passageway 32 on the periphery of the bushing 24. The passageway 32
extends from the radially exterior surface 55 through the opposite
radially interior surface 53. The bushing 24 has a first relaxed
position 85 which represents the shape of the bushing 24 when not
assembled into the plate 14. The bushing 24 further has an
assembled position 87 as shown in the dotted line. The assembled
position 87 represents when the bushing 24 is placed within the
plate 14 and when the screws are not installed. The bushing 24
further has an expanded position 88 shown in phantom in which the
bushing 24 is shown with the bushing 24 installed in the plate 24
and the screws installed within the bushing 24.
[0068] As can be seen in FIG. 15, the bushing 24 is contracted when
the assembled position 87 to provide for an interference fit
between the bushing 24 and the plate 14. Further as shown in FIG.
15, the bushing 24 is expanded as it moves from the assembled
position 87 to the expanded position 88. This occurs because the
tapered threads during engagement cause the bushing 24 to enlarge.
The enlarging of the bushing 24 causes a tighter interference
between the bushing 24 and the plate thereby securely locking the
bushing in its polyaxial oriented position with minimal stress.
[0069] Referring now to FIG. 16 a cross-section of the bushing 24
is shown. As shown in FIG. 16 preferably the bushing 24 has a
spherical radius R.sub.S which defines the radial exterior surface
26 of the bushing 24. By providing a spherical radius R.sub.S the
bushing 24 may be oriented into a number of angular positions with
respect to the plate.
[0070] Referring to FIG. 16 the internal threads 82 of the bushing
24 have a taper defined by an internal angle .beta..beta..beta..
The angle .beta..beta..beta. maybe, for example, from 3 to 30
degrees. As shown in FIG. 16 the truncated spherical shape of the
radial exterior surface 26 may be modified by corner radius R.
[0071] While the fracture repair system of the present invention
includes the bushing to provide for positioning of the attachment
component in a variety of diverging directions while providing for
reduced stress at the plate, when percutaneously securing a bone
screw to a bone plate location which does not provide for the
pivotal securement of the bushing arrangement, it is critical that
the screws in such fixed locations be properly positioned.
Referring now to FIG. 17 preferably the femur plate 14 is used in
conjunction with drill guide 200. Drill guide 200 is installed onto
the femur plate 14 during surgery and is utilized to guide drills
and screwdrivers to properly orientate the screws that are placed
in the proximal portion of the plate 14. The drill guide 200
includes a locating feature 202 in the form of, for example, an
elongated pin which closely fits to the elongated slots of a plate.
The drill guide includes a riser portion 204 and a bar portion 206
which is positioned parallel and spaced from the plate 14.
[0072] The bar portion 206 includes a series of bushing holes 210
which are in alignment with the center of the elongated openings 54
in the plate 14. To properly secure the drill guide 200 to plate
14, for example, the drill guide 200 may include a securing screw
214 which maybe slidingly fitted to an opening 216 in the riser
portion 204 and which may be secured to tapped opening 60 in the
plate 14.
[0073] The drill guide 200 may be utilized both in conventional
open surgery and in percutaneous surgery. When utilized in
percutaneous surgery the bushing holes 210 may be utilized to guide
trocars which will open the skin and tissue around the openings
permitting the screws to be properly secured. Since the human
anatomy is generally symmetrical, the drill guide 200 is either a
right hand or left hand drill guide and the right hand and
left-hand drill guide are different, but generally symmetrical with
each other. It should be appreciated that the drill guide may be
utilized for any bone plate for supporting any long bone for
example a tibia, humerus, ulna, radius or fibula.
[0074] While heretofore the fracture repair system has been
described in more detail as a femur plate, it should be appreciated
that the plate may be utilized for supporting any long bone for
example a tibia, humerus, ulna, radius or fibula.
[0075] Referring now to FIGS. 7-9 and 11, a tibia plate 314 for
installation onto a tibia 312 is shown. The fracture repair system
310 for use on the tibia 312 includes a tibia plate 314 having a
body portion 316. The body portion 316 includes a distal portion
342 and a proximal portion 344. The tibia plate 314 like the femur
plate 14 is preferably positioned laterally on the long bone. The
lateral position of the tibia plate reduces the amount of soft
tissue that must be dislocated to position the tibia plate 314.
Since the human anatomy is generally symmetrical, the tibia plate
314 is either a right hand or left hand tibia plate and the right
hand and left-hand tibia plates are different, but generally
symmetrical with each other. The proximal portion 344 of the tibia
plate 314 is designed to follow the general contours of the lateral
proximal tibia. The proximal portion 344 of the plate 314 is
contoured to fit the lateral condyle 350 of the condylar portion
346 of the tibia 312. The body portion 316 of the tibia plate 314
like the body portion 16 of the femur plate 14 has a generally
arcuate cross-section to conform with the distal shaft of the tibia
312.
[0076] The tibia plate 314 like the femur plate 14 may be made of
any suitable durable material that is compatible with the human
immune system and may for example be made of a durable
non-corrosive material such as stainless steel, cobalt chrome or
titanium. For example, the tibia plate may be manufactured from a
forged or wrought titanium alloy. For example, such a titanium
alloy may be ASTM F-620-97 or ASTM F-136 ELI.
[0077] Referring now to FIG. 7, the tibia plate 314 may be inserted
into the human anatomy percutaneously or by conventional open
surgery. When inserted by conventional open surgery, the leg 308 is
cut with a longitudinal incision 390 of length roughly equal to
that of the tibia plate 314. The soft tissue is moved away from the
tibia 312 and the tibia plate 314 is placed against the tibia 312.
Screws such as those for the femur plate are utilized to secure the
tibia plate 314 to the tibia 312. If the tibia plate 314 is to be
inserted percutaneously, a smaller longitudinal incision 392 is
made in the skin of the leg 308 near the knee and the distal
portion 342 of the body portion 316 of the tibia plate 314 is
inserted in the incision 392 in the direction of arrow 306 toward
the distal portion of the leg. A contoured tip 384 on the distal
portion of the 342 of the tibia plate of the tibia plate 314 is
shaped to ease the insertion of the tibia plate along the contour
of the tibia 312 in the direction of arrow 306.
[0078] For installation either percutaneously or by conventional
open surgery of the tibia plate 314 drill guides (not shown) such
as drill guide 200 for the femur plate as shown in FIG. 17 are
utilized. Again, as with the femur plate, the drill guide may be
utilized to guide the drill and the screws whether the plate and
screws are inserted percutaneously or by conventional open surgery.
It should be appreciated that a left-hand drill guide (not shown)
and a right hand drill guide (not shown) are necessary respectively
for the right hand and left-hand tibia plates (not shown).
[0079] Referring now to FIG. 8, the tibial plate 314 may be made of
sufficient dimensions to properly support the tibia 312. The proper
dimensions of the tibial plate 314 are dependent thus on the size
of the particular tibia to be treated as well as the inherent
strength of the material from which the tibial plate 314 is made.
For example, the tibial plate 314, if made of titanium, may have a
thickness TT (see FIG. 9) of, for example, approximately {fraction
(1/16)} to {fraction (1/14)} of an inch and a WW width of around
1/4 to 3/4 inch and a length LL of, for example, from 5-10 inches.
To provide for a range of standard tibial plates, the tibial plates
may be provided in varying lengths of, for example, a length with a
number of elongated openings 354 of, for example, 4, 7, 11, or 14
elongated openings.
[0080] According to the present invention and referring to FIGS.
7-9 and 11, the tibial plate 314 includes the body portion 316
which conforms at least partially to the contour of the tibia 312.
The tibia plate 314 also includes an interior wall 320 which
defines a tibia plate hole 322 through the body portion 316.
[0081] Referring to FIG. 9, the tibial plate 314 further includes
one or more bushings 324. The bushing 324 includes a radially
exterior surface 326 and an opposite radially interior surface 330.
The opposite radially interior surface 330 defines a passageway 332
there through. The exterior surface 326 of the bushing 324 and the
interior wall 320 (see FIG. 9) of the plate 314 cooperate with each
other and are configured to permit polyaxial rotation of the
bushing 324 within the plate hole 322. The tibial plate 314 further
includes an attachment component 370 in the form of, for example, a
cancellous screw. The screw 370 includes a distal portion 336 sized
for clearance passage through the passageway 332 and into the
cancellous bone 394.
[0082] The screw 370 further includes a proximate portion 340 sized
to press the bushing 324 against the inner wall or surface 330 of
the plate 324 to form a friction lock between the bushing 324 and
the plate 314 in a selected polyaxial position. For example, the
cancellous screw 370 may be in a first polyaxial position 372 as
shown in solid line 372 (see FIG. 11). Alternatively, the
cancellous screw 370 may be oriented an angle .alpha..alpha. from
the first position 372 into a second position 374 as shown in
phantom. Alternatively, the cancellous screw 370 may be positioned
in, for example, a third position 376 positioned at an angle
.beta..beta. from the first position 372. The cancellous screw 370
may thus be positioned with a diverging angle .alpha..alpha. or
.beta..beta. from the first position 372.
[0083] Preferably and as shown in FIG. 11, the proximal portion 340
of the cancellous screw 370 includes external tapered threads 380
which mate with internal threads 382 located within the bushing
324. By providing tapered threads as the cancellous screw 370 is
screwed into the bushing 324, the bushing 324 expands with the
radially exterior surface 326 of the bushing, seating and securing
against the radially interior surface 330 of the plate 314. This
provides for stress-free, secure locking of the screw 370 to the
plate 314.
[0084] Alternatively, the attachment component which mates with the
bushing 324 may be provided without any threads in the proximal
portion of the attachment component similarly to the screw 170 of
FIG. 6A. Such a screw will provide for polyaxial positioning of the
attachment component with reduced stress. The screw 56 unlike
cancellous screw 70 (see FIG. 6) does not include threads on the
head of screw 56. The lack of screw threads on the head of screw 56
allows the head to spin on the bushing 24 without locking, thereby
achieving a lagging effect.
[0085] By positioning the cancellous screw 370 into the first
position 372 or the second position 374 or the third position 376,
the screw 370 may be positioned to properly secure fragments. For
example as shown in FIG. 9 the cancellous screw 370 being
positioned in second position 374 may provide for the securing of a
fragment CC while the positioning of the cancellous screw 370 in
the third position 376 may provide for the securing of fragment
DD.
[0086] The fracture repair system 310 for use for repairing a
fractured tibia may include additional attachment components such
as additional attachment component 370. Thus the fracture repair
system may include a second cancellous screw 370 positioned at a
second plate hole (not shown). In addition to a plurality of
cancellous screws 370, the fracture repair system 310 may include,
in addition to the polyaxial screws, additional cancellous or
cortical screws. For example, Referring to FIGS. 9 and 11, the
repair system 310 may include fully threaded cortical screws 352
similar to the cortical screws 52 of the femur plate 14. The
cortical screws 352 preferably extend through the cancellous bone
394 and engage with the cortical bone 396. The fracture repair
system 310 may further include cancellous screws for example
cancellous screws 356 located in the proximal portion 344 of the
bone plate 314 as shown in FIG. 11. Such cancellous screws 356 are
preferably of a length short enough that they do not reach through
to the opposed cortical bone 396. The tibial plate 314 may include
one or more tapped openings 360 in the tibial plate 314 which may
be utilized to secure a drill guide (not shown), similar to the
drill guide 200, for aligning a drill and a screw driver for the
insertion of the screws 352 into the tibia.
[0087] Referring now to FIGS. 1 and 2 a fracture repair system 710
is shown. The fracture repair system 710 comprises an assembly of
both a femur plate 14 and a tibia plate 1 14. Frequently the
polyaxial plates of the present invention are sold as a fracture
repair system 710 including both a tibial plate 114 and a femur
plate 14. Such a combination is often required in severe knee
trauma caused, for example, in front-end auto accidents. It should
be appreciated that a fracture repair system may include a plate
for any other long bone for example a humerus, ulna, fibula or
radius.
[0088] By providing a fracture repair system including a bushing to
permit polyaxial rotation of the bushing within the hole plate an
attachment component may be secured to a plate with the ability to
position divergently to secure the fracture of the bone most
efficiently. For example bone fragments may be reached by orienting
the attachment component relative to the plate in such a direction
to reach various bone fragments.
[0089] By providing a fracture repair system including a bushing
with a spherical outside diameter in cooperation with a plate
having a spherical bore, a low-friction polyaxial rotation of the
attachment component relative to the plate is possible.
[0090] By providing a fracture repair system including a bushing
having a tapered threaded bore in cooperation with a tapered
threaded or non-threaded attachment component, the attachment
component may be rigidly secured in a variety of orientations.
[0091] By providing a fracture repair system including a polyaxial
bushing which maybe rigidly secured to a plate and including a
closely conforming plate which closely conforms to the condyle
areas of a long bone the fragments fractured components within the
condyle areas may be effectively and efficiently contained.
[0092] By providing a fracture repair system including a threaded
alignment hole for securing a jig for drilling and threading the
plate to the bone perpendicularly, a simple to use effective
efficient bone plate system can be provided.
[0093] By providing a bone plate including a contoured tip for
percutaneous insertion, a bone plate may be provided percutaneously
for minimally invasive surgery. Such a contoured tip permits easy
and effective insertion and alignment of the plate to the bone.
[0094] Although the invention has been described in detail with
reference to a preferred embodiment, variations and modifications
exist within the scope and spirit of the invention as described and
defined in the following claims.
* * * * *